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RICHARD A. BERG, PC

Clinical Neuropsychologist

Wilmington, North Carolina

Provider NPI: 1184717605

Organization Information:
Organization Name:  RICHARD A. BERG, PC
Organization is not Subpart
Authorized Official:  RICHARD A. BERG  NEUROPSYCHOLOGIST/PSYCHOLOGIST  910-7915719

Practice Location:
5010 RANDALL PARKWAY  WILMINGTON, NC 28403 US
Tel: 910-791-5719  Fax: 910-799-8180

Business Mailing Address:
5010 RANDALL PARKWAY  WILMINGTON, NC 28403 US
Tel: 910-791-5719  Fax: 910-799-8180

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NC1976
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
NC1976

Other Provider Identifiers:

IssuerNumberStateType
AETNA577707101
MEDCOSTB523201
BLUE CROSS BLUE SHIELD0334HNC01
MAGELLAN0774001
VALUE OPTIONS280096/A20624401
UNITED HEALTH CARE/UBH61-0049601
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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